Atherosclerosis in Systemic Sclerosis: a Modern Controversy

Area of Science:

• Rheumatology
• Cardiology
• Vascular Medicine

Background:

• Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by microvascular damage.
• Evidence suggests macrovascular involvement and accelerated atherosclerosis in SSc patients, similar to other autoimmune conditions.
• Elevated cardiovascular and cerebrovascular mortality rates in SSc underscore the need to investigate atherosclerosis.

Purpose of the Study:

• To synthesize current evidence on atherosclerotic involvement in Systemic Sclerosis (SSc).
• To review the association between SSc and established atherosclerosis risk factors.
• To summarize studies comparing atherosclerosis in SSc patients versus control groups.

Main Methods:

• Review of recent literature on atherosclerosis in Systemic Sclerosis.
• Analysis of studies assessing subclinical atherosclerosis using various imaging and physiological techniques.
• Comparative analysis of SSc patients and healthy controls regarding atherosclerosis prevalence and severity.

Main Results:

• Inconsistent results reported across studies assessing subclinical atherosclerosis in SSc, irrespective of the methodology used.
• Atherosclerosis assessment tools like intima media thickness, pulse wave velocity, and coronary angiotomography have yielded non-concordant findings.
• The association between SSc, its risk factors, and the extent of atherosclerosis requires further clarification.

Conclusions:

• The precise extent and clinical significance of atherosclerosis in Systemic Sclerosis remain uncertain.
• Further research combining multiple atherosclerosis assessment tools and larger patient cohorts is essential.
• Elucidating the role of atherosclerosis in SSc is crucial for understanding disease progression and cardiovascular risk.